New Ways to Highlight EBP at Murrieta

Seeking a new way to highlight LLU Medical Center – Murrieta, nursing staff who were attaining their doctor of nursing practice degrees, as well as the resources and practices related to evidence-based practice (EBP), the nursing leadership at Murrieta hospital and the director of Nursing Research developed the “EBP Action Faction.”

The “EBP Action Faction” is a way for LLU Medical Center – Murrieta students to share their evidence-based projects with the hospital staff and leadership. The event is held quarterly and consists of staff presentations, as well as the presentation of information on EBP technology, resources, problem identification and question development. Additional content is provided upon request by nursing staff or leadership. The EBP projects presented to date include:

Evelyn Kelley, DNP, BSN, RN, PCCN (Heart Failure, Third Floor)

Evelyn developed a Congestive Heart Failure (CHF) Education Passport. This project was chosen because in the surrounding area, more than 24% of the population are older adults (65 years and older). Furthermore, a review of hospital admissions revealed an increased number of readmissions due to exacerbations of CHF. As a personal goal, Evelyn also wanted to increase the community’s knowledge of CHF management and improve the quality of life for CHF patients. She found that patients used and found the passports to be valuable, and that it increased their knowledge of their disease. Nursing staff is sustaining the project, and it is contributing to the hospital’s endeavors related to reducing readmissions, and meeting Inland Empire Health Plan (IEHP) quality goals for patients with heart failure. As a hospital, we had to create a process improvement plan for IEHP CHF readmissions. Our overall goal is to reduce the number of readmissions. We plan to do that by using Evelyn’s project throughout the hospital, focusing on scheduling seven day follow-up appointments for all CHF discharges and appropriate referrals to care partners for the appropriate patients at time of discharge. We will have monthly steering committee meetings and submit our data to IEHP in March 2023.

Jose Lupian, DNP, RN (Cardiac Catheterization Lab, Second Floor) associated documents. While her sample was small, there were impressive outcome measures.

Jose’s DNP project focused on the “Use of Essential Oils in Managing Pre-operative Anxiety.” Jose chose his project because there was no formal procedural plan to reduce anxiety in patients undergoing cardiac procedures in the catheterization laboratory. His baseline data revealed that patients undergoing cardiac procedures were stressed and anxious. The literature supported the findings that in cardiac patients, these feelings can negatively impact their vital signs, causing increased heart rate and blood pressure. Jose sought to reduce the patient’s anxiety, improve the patient experience, improve patient satisfaction, and increase their compliance with treatment regimens. His outcomes revealed a 34.79% overall reduction in reported anxiety (P-value* <0.001).

Melissa obtained positive feedback from the participants and mentors. The mentees felt that the program helped them adapt and feel welcomed. The mentees enjoyed the confidential resource while the mentors felt inspired to help new hires in their experience.

Her project measures will be evaluated at six months and one year, and the ED nurse retention numbers will be examined after 12 months.

Roxanna Stead, DNP, RN (Critical Care Resource Nurse)

Post-intervention outcomes reported an increase in nursing knowledge.

Additionally, there were a total of 11 hypoglycemic events for July and August 2022, and when the data was normalized, factoring in the total number of inpatient days, the aggregated data revealed a decrease of 0.06%, when compared to 0.53% for July 2021.

Melissa

Hamilton, DNP, RN (Emergency Department)

Melissa’s project was entitled, “Implementation of a Mentorship Program in an Emergency Department to Address Job Satisfaction and Intent-to-Stay.” She chose this project because of the high ED RN turnover. New staff voiced concerns of feeling lost when hired, there was opportunity for team building, and to increase camaraderie.

Melissa created a Mentorship Program that included a five-page informational packet with

Roxanna’s project focused on preventing hypoglycemia events among hospitalized patients by implementation of the Hypoglycemia Risk Stratification Tool. The project involves nurses on the fourth floor Medical Telemetry Unit as they assess patients for hypoglycemia risk factors using the proposed Hypoglycemia Risk Stratification Tool, adjust the treatment plan by contacting the attending provider, and suggest changes based on the low, intermediate, or high-risk factors. They will then adapt the changes into the plan of care. This project was chosen because in 2021, 74% of the adverse drug events at LLU Medical Center – Murrieta were hypoglycemia events.